Independence Center

LBN: Independence Center
Independence Center is an health care organization with primary practice located at 4245 Forest Park Ave , Saint Louis MO 63108-2810. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Independence Center can be contacted via phone (314) 880-5415, or through Holmes, Patricia via phone (314) 880-5415.

Contact Information

Primary practice address
4245 Forest Park Ave Saint Louis MO 63108-2810
Phone: (314) 880-5415
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Holmes, Patricia
Phone: (314) 880-5415

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1558494286
LBN Legal business name Independence Center
DBA Doing business as
Authorized official Holmes, Patricia
Entity Organization
Organization subpart 1 No
Enumeration date Mar 13th, 2007
Last updated Jun 27th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558494286 NPPES
Missouri MEDICAID 876173501

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